The questions that we encounter in the board exams may describe the heart murmurs by characteristic. This can be confusing since valve disorders may create different types of murmurs. In order to make it more simple, we can use this USMLE Approach to heart murmur questions to understand how this murmurs will be described in the questions. For example, murmurs can be holosystolic, early diastolic or decrescendo, crescendo decrescendo, mid to late murmurs.
What makes the difference?
Here we have the “USMLE Approach to heart murmur questions”:
As you can appreciate in this classification, there is a similarity between semilunar valves like aortic or pulmonary and their description. For instance, if there is a stenotic area in the semilunar valves (aortic or pulmonary), it will cause a “crescendo decrescendo like murmur” for both, thus the main difference between pulmonary vs aortic stenosis is the area where it is mostly heard: right second intercostal space along the sternal border for aortic stenosis and left second intercostal space along the sternal border for pulmonary stenosis.
The same similarity occurs with the auriculo-ventricular valves. This helps a lot to remember that they will be described in the same way but their location is what differs.
I will try to make an explanation of the nature of these murmurs and why they produce these unique characteristics in a future revision.
If you have any question or comment about this topic, please leave your opinions below in the comment section.
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